Hospitals and health care facilities are keeping a wary eye on the U.S. Environmental Protection Agency, awaiting the latest word on the agency’s efforts to regulate the incineration of medical wastes. Under the pending guidelines, some predict that many of the nation’s remaining 57 medical waste incinerators will be unable to meet the costs or the technological challenges of retrofitting their units to meet the more stringent emission requirements and will be forced to shut down. That could mean hospitals and others would have to outsource the burning of wastes to a handful of surviving commercial companies.

“It’s our impression that this [EPA regulation] is obviously the wrong idea,” says William Christie, facility director at Bayfront Medical Center in St. Petersburg, Fla. “It would probably put an unfair financial burden a health care system that is already stretched to the max. They’re just piling it on. There’s plenty of health care problems and you’re just adding more dollars to them.”

Christie notes that until the EPA issues its final guidelines — the comment period on the proposed changes ended Feb. 17 — there was no way to determine the actual costs to the hospital. However, the EPA estimates that the cost for the 57 currently operating HMIWI (hospital, medical and infectious waste incinerators) to comply with the rule revisions will be approximately $21.1 million per year. “EPA also estimates that the cost of an available disposal alternative would be about $10.6 million, or roughly half of the estimated compliance costs,” it says.

Of the 57 incinerators in operation nationwide, 14 are commercial operations, 29 are at hospitals, six are at federal facilities and four each are at universities and pharmaceutical firms, according to EPA. Those incinerators burn 146,000 tons of medical waste each year. The new guidelines would reduce that by 468,000 pounds per year, the EPA estimates. In 1997, when EPA first issued its standards for medical waste incinerators, there were approximately 2,400 incinerators nationwide, burning an estimated 830,000 tons of medical waste annually.

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